- CAI (Charleston, WV)
- …Type** Full time **Worksite Flexibility** Remote **Job Summary** We are looking for a motivated Case Manager , RN ready to take us to the next level! If you ... move, apply now. **Job Description** We are looking for a Case Manager , RN to provide community-based care coordination/management for our client's members… more
- Select Medical (Charleston, WV)
- **Overview** **Critical Illness Recovery Hospital** ** Case Manager (PRN)** _Requires a current licensure in a clinical discipline either as a Nurse or a ... high-quality care and doing well by doing what is right. The Case Manager is responsible for utilization reviews and resource management, discharge planning,… more
- Elevance Health (Charleston, WV)
- **Behavioral Health Case Manager II** **Location: West Virginia.** This is a field based role servicing members in the Beckley, Princeton, Morgantown or ... providers in person (field) 2-3 days per week. The **Behavioral Health Case Manager II** is responsible for performing case management telephonically and/or… more
- Sedgwick (Charleston, WV)
- …Great Place to Work(R) Most Loved Workplace(R) Forbes Best-in-State Employer RN Field Case Manager **Looking for** **experienced** **Workers Comp RN Field ... Case Manager Nurses across multiple states in the country to...involved parties.** **PRIMARY PURPOSE OF THE ROLE:** Sedgwick Field Case Managers work face to face with their injured… more
- Cardinal Health (Charleston, WV)
- …get life-changing therapies to patients who need them-faster.** **_Responsibilities_** The Case Manager supports patient access to therapy through Reimbursement ... Support Services in accordance with the program business rules and HIPAA regulations. This position is responsible for guiding the patient through the various process steps of their patient journey to therapy. These steps include patient referral intake,… more
- Cardinal Health (Charleston, WV)
- …get life-changing therapies to patients who need them-faster.** **_Responsibilities_** The Case Manager supports patient access to therapy through Reimbursement ... Support Services in accordance with the program business rules and HIPAA regulations. This position is responsible for guiding the healthcare providers through the various process steps in support of their patient's journey to therapy. These steps include… more
- Highmark Health (Charleston, WV)
- …the appropriate clinical interventions and referrals, the incumbent will manage an active case load of members in his/her panel that are enrolled in case ... management. The incumbent conducts outreach to members enrolled in case management including but is not limited to: developing a care plan, encouraging behavior… more
- BrightSpring Health Services (Winfield, WV)
- …pre-screening assessments, completion of pre-screening reports, and preparation of case proposals and other related pre-admission paperwork (ie, obtains ... levels with third party payer. + Contacts referral sources to advise them of case acceptance and provides information on the clinical team responsible for client's … more
- Holzer Health System (Gallipolis, OH)
- Works under the supervision of the Manager /Director of Home Care. Assesses, plans, implements, evaluates, and supervises individual patient care to patients in their ... working in the Home Care department. Citations will be reviewed on a case by case basis. + No criminal record as validated by criminal background check,… more
- Cardinal Health (Charleston, WV)
- …members **Responsibilities** * Handle customer escalated cases through investigation and case review * Contact customers to confirm approval/denials of coverage, ... doctors and/or patients checking on the status of the case * Maintain quality while providing an empathetic and...* Support manufacturer field team members as required on case updates * Works internally with team members regarding… more
- Travelers Insurance Company (Charleston, WV)
- …with insured based on application of policy information to facts or allegations of each case . + Consult with Manager on use of Claim Coverage Counsel as needed. ... as strategically appropriate. + Complete outside investigation as needed per case specifics. + Utilize evaluation documentation tools in accordance with department… more
- Humana (Charleston, WV)
- …+ BSN or an advanced degree in nursing or business-related field. + Certified Case Manager (CCM). + Previous experience working in a managed care field. ... help us put health first** Humana Healthy Horizons in Virginia is seeking a Manager , Care Management (Maternal-Child Health) who will lead teams of nurses and health… more
- Humana (Charleston, WV)
- …coaching, performance review, up to termination. + Certified or certified-eligible case manager required. **Additional Information:** **Workstyle:** Remote work ... part of our caring community and help us put health first** The Manager , Utilization Management Behavioral Health utilizes behavioral health knowledge and skills to… more
- Elevance Health (Charleston, WV)
- …in forming a supportive, peer recovery network. + Assist members in working with their case manager or treatment team in determining the steps he/she needs to ... both written and verbal. + Knowledge of care-coordination and case management concepts strongly preferred. + BA/BS or MBA...Strategy. Unless specified as primarily virtual by the hiring manager , associates are required to work at an Elevance… more
- Holzer Health System (Gallipolis, OH)
- …of the Director for Hospice and under the direct supervision of the RN Case Manager . Completes basic personal care, respite/companionship duties for patients at ... their place of residence; within the hospital system; general inpatient; and any facilities, system or community, depending on the patient placement and according to policies and procedures. Education, Work Experience and Licensure: . High school graduate or… more
- ASM Research, An Accenture Federal Services Company (Charleston, WV)
- The Bilingual Case Management Analyst III is responsible for efficient and timely hands-on troubleshooting, remediation, coordination, escalation, tracking and ... the project goals, will complement the role as a case analyst. + Employee is expected to undertake any...expected to undertake any additional duties as assigned by manager . **Minimum Qualifications** + Bachelor's Degree or equivalent **OR**… more
- Travelers Insurance Company (Charleston, WV)
- …with insured based on application of policy information to facts or allegations of each case . + Consults with Manager on use of Claim Coverage Counsel as needed. ... to make independent decisions on most assigned cases without involvement of Claim Manager . + Openness to the ideas and expertise of others actively solicits input… more
- Travelers Insurance Company (Charleston, WV)
- …with insured based on application of policy information, facts or allegations of each case . Consults with Unit Manager on use of Claim Coverage Counsel. + ... fraud investigators and to other experts. Requests through Unit Manager and coordinate the results of their efforts and...referred timely to next level claim professional or Major Case Unit. + Appropriately deals with information that is… more
- Sharecare (Charleston, WV)
- …telephonic Case or Care Management with members. The Care Manager partners with members, caregivers, providers, and the interdisciplinary care team to ... for everyone. To learn more, visit www.sharecare.com. **Job Summary:** The Care Manager supports the implementation of the Value Based Care Management program in… more
- CenterWell (South Charleston, WV)
- …the delivery of care to all patients served by the location. Receives case referrals. Reviews available patient information related to the case , including ... admit patients to service. Assigns appropriate clinicians to a case , as needed. + Instructs and guides clinicians to...of home health services, and fourth largest pharmacy benefit manager , CenterWell is focused on whole-person health by addressing… more